The goal of this clinical trial is to learn whether expansile duraplasty can improve neurological recovery in adult patients with acute severe traumatic spinal cord injury, as well as evaluate the safety of this surgical strategy. The main questions the study aims to answer are:
1. Does expansile duraplasty lead to superior motor function recovery in patients with acute severe traumatic spinal cord injury?
2. How safe is the use of expansile duraplasty in people with acute traumatic SCI?
Researchers will compare neurological function, quality of life and all safety indicators who receive expansile duraplasty to that of participants who do not receive expansile duraplasty, to determine whether the additional expansile duraplasty provides better recovery benefits for patients with traumatic spinal cord injury.
Participants will be randomly assigned to one of two groups: the laminectomy combined with expansile duraplasty group and the laminectomy-only group. All participants will complete the following procedures:
1. Receive standardized spinal surgery ;
2. Provide blood and cerebrospinal fluid samples during hospitalization;
3. Undergo spinal computed tomography (CT) and magnetic resonance imaging (MRI) scans at baseline (pre-operation), discharge, 3 months, 6 months and 12 months after surgery;
4. Complete standardized neurological assessments at 3, 6 and 12 months postoperatively, including ASIA motor and sensory scores, Walking Index for Spinal Cord Injury II (WISCI II), and Spinal Cord Independence Measure III (SCIM III);
5. Fill out questionnaires at each follow-up visit, including the 36-Item Short Form Health Survey (SF-36);
6. Be continuously monitored for all adverse events and surgical complications throughout the 12-month follow-up period.